title: Prognostic factors of young women (≤ 35 years) with node positive breast cancer: possible influence on post-therapeutic follow-up.
abstract: OBJECTIVE
  Although young age at diagnosis is an independent prognostic factor of poor survival; no specific recommendation are provided concerning the timing and modalities of follow-up for this population. These patients are followed similarly to older women during post-therapeutic surveillance. The objective of this study is to examine patterns of recurrence in a large series of positive lymph node breast cancer women aged 35 years or below and treated within adjuvant chemotherapy trials.
  
  
  METHODS
  Data of 200 patients (≤ 35 years) included in three UNICANCER adjuvant trials for node positive breast cancer were used. Competing risks methodology was used to identify prognostic factors associated with time to first failure according to type of event.
  
  
  RESULTS
  After a median follow-up of 52.4 months, 84 pts had disease related events (17 loco-regional, five contralateral, and 62 distant metastasis). Variables associated with an increased rate of first event were the number of involved lymph nodes and the type of surgery. In univariate analysis, prognostic factors associated with high potential curative recurrence were number of positive lymph nodes and vascular invasion. Only number of positive lymph node remained significant in multivariate analysis. Concerning distant metastasis, only the number of lymph node involved was associated to an increased risk of metastasis.
  
  
  CONCLUSIONS
  Using the number of positive nodes as important prognostic factors, it should be possible to identify patients at a higher risk of locoregional relapse or contralateral breast cancer, in order to propose more individualized follow-up.
authors.affiliation: Institut Claudius-Regaud, 20-24 rue du Pont-Saint-Pierre, 31052 Toulouse, France. filleron.thomas@claudiusregaud.fr
authors.forename: Thomas
authors.initials: T
authors.lastname: Filleron
authors.forename: Florence Dalenc
authors.initials: FD
authors.lastname: Md
authors.forename: Andrew
authors.initials: A
authors.lastname: Kramar
authors.forename: Marc
authors.initials: M
authors.lastname: Spielmann
authors.forename: Christelle
authors.initials: C
authors.lastname: Levy
authors.forename: Pierre
authors.initials: P
authors.lastname: Fumoleau
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Canon
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Martin
authors.forename: Henri
authors.initials: H
authors.lastname: Roché
mesh_terms: D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D001943:Breast Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology*; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D016609:Neoplasms, Second Primary / Q000473:pathology; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors; D055815:Young Adult
keywords: breast cancer; competing risks; follow-up; local-recurrence; prognostic factor; survival analysis; young women